How much rates vary
Facilitymedian $661 · 10th to 90th $407 to $4,266Professionalmedian $479 · 10th to 90th $263 to $776
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $501.19 | Professional | None | $234.42 | $323.59 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,238.72 | Facility | None | $660.69 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $812.83 | Professional | None | $269.15 | $478.63 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $851.14 | Professional | None | $346.74 | $501.19 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $6,606.93 | Facility | None | $371.54 | $831.76 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $691.83 | Professional | None | $263.03 | $457.09 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $676.08 | Facility | None | $398.11 | $645.65 | $676.08 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $2,238.72 | Facility | None | $446.68 | $1,318.26 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $812.83 | Professional | None | $79.43 | $467.74 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $660.69 | Professional | None | $354.81 | $602.56 | $660.69 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $851.14 | Professional | None | $275.42 | $501.19 | $851.14 |
13 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $251.19 | Professional | 52 · Reduced service | $131.83 | $131.83 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $53.70 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $199.53 Typical High $380.19 | Professional | 54 · Surgery only | $194.98 | $199.53 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $75.86 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $186.21 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $181.97 | $186.21 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $251.19 | Professional | 52 · Reduced service | $131.83 | $131.83 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $52.48 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $380.19 | Professional | 54 · Surgery only | $194.98 | $194.98 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $75.86 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $354.81 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $8,317.64 Typical High $9,549.93 | Facility | 50 · Both sides | $6,025.60 | $8,317.64 | $9,549.93 |
Where Oregon sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $5,125ND $804
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.